Venous Ulceration

What is a venous leg ulcer?

It is a shallow wound that happens when the veins in your legs are unable to properly pump un-oxygenated blood to your heart. This is called venous insufficiency and causes blood to pool inside your lower legs.

Venous ulcers are a due to an ongoing or chronic problem and usually happens in older people, however venous ulcers can occur at a younger age. You are more likely to get them if you have varicose veins, darkening pigmentation in the lower leg, are overweight, or have had a leg injury or blood clot.

How do I know if my wound is a venous ulcer?

Have your leg seen by a vascular specialists! Venous ulcers are usually located on the inner lower legs, especially on the ankles, and don't heal on their own. The skin around the wound is usually discolored, dark, tight or red. You may also have a dull ache or pain and swelling in your lower legs.

How are venous ulcers treated?

Venous ulcers are usually treated with bandages or stockings that put pressure on your legs. Some of these are worn 24 hours a day and need to be replaced by a doctor or home health nurse every few days. Others are worn only during the day, and you can put them on and take them off yourself. Your doctor may recommend gels or foams to put under the bandage to help the wound heal.  Sitting or lying down with your leg raised for 30 minutes, three or four times a day, can keep the swelling down. Your doctor may give you medicine to help the blood flow through your legs better.  

Is there a vascular treatment for my venous ulcer?

One of the key elements to wound healing is an accurate vascular assessment. A highly skilled registered vascular sonographer can determine the problems in the venous or arterial system that is causing the ulcer to remain open. Typically this is due to scarring in the deep veins and incompetent perforating veins in the lower leg. Blood is supposed to flow from the surface to the deep system. When you have deep vein disease the pressure can cause the blood to flow from the inside of the leg to the outside of the leg. This is through perforating veins (connect the surface and the deep system). When a perforator vein enlarges this can cause major problems in the venous system.  Your surgeon can close this perforator and thus eliminate the venous pressure to the ulcerated area of the skin. It is not unusual for someone to suffer years with ulcers only to have them closed when the proper diagnostics and tools are used to treat the area.